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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

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Focal ST-segment elevation without coronary occlusion: myocardial infarction with no obstructive coronary

Casey Meizinger1, Bruce Klugherz2

  • 1Department of Internal Medicine, Abington Hospital, Jefferson Health Abington, 1200 Old York Road PA, 19118, USA.

European Heart Journal. Case Reports
|March 26, 2021
PubMed

Insights

This case report highlights a patient with COVID-19 who experienced myocardial infarction with no obstructive coronary atherosclerosis (MINOCA). It emphasizes that not all myocardial injury in COVID-19 is due to blocked arteries, necessitating further research into cardiovascular complications.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Coronavirus disease 2019 (COVID-19) is known for respiratory failure but also presents cardiovascular complications.
  • A subset of COVID-19 patients exhibit ST-elevations on ECG with normal coronary angiography, fitting criteria for myocardial infarction with no obstructive coronary atherosclerosis (MINOCA).
  • Non-coronary myocardial injury in COVID-19 patients requires further investigation.

Purpose of the Study:

  • To present a case of COVID-19 associated with MINOCA.
  • To underscore the importance of considering non-obstructive coronary artery disease causes for myocardial injury in COVID-19.
  • To encourage further research into the cardiovascular manifestations of COVID-19.

Main Methods:

  • Case report of an 86-year-old male with acute hypoxic respiratory failure and ECG findings suggestive of myocardial infarction.
  • Initiation of mechanical ventilation and performance of transthoracic echocardiography.
  • Coronary angiography revealing no obstructive coronary artery disease; COVID-19 positivity confirmed.

Main Results:

  • The patient presented with ST-segment elevation on ECG and confirmed COVID-19.
  • Coronary angiography showed no significant coronary artery disease, consistent with MINOCA.
  • Despite intensive care, the patient's outcome was unfavorable.

Conclusions:

  • The presented case suggests a likely association between COVID-19 and MINOCA.
  • It is critical to recognize that myocardial injury in COVID-19 may not stem from obstructive coronary artery disease.
  • Consideration of hypoxic respiratory failure, myocarditis, and systemic inflammation is vital in COVID-19 cardiovascular complications.
Abstract

Keywords:
COVID-19Case reportCoronavirus disease 2019MINOCASARS-CoV-2ST-segment elevation

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